Clean EMG 3 months after onset of symptoms

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Seth Petraroli

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Hi,

I've bee having weakness in both of my quads and left arm, and it started with balance issues 3 months back (I can't lift the same weight at the gym, and it's hard to walk). Also, I have hyporeflexia in my arms and hyperreflexia in my knees, but they are symmetric.

I've seen a als specialist and a neuro; the specialist thinks I'm okay, and the neuro did not say one way or the other; he says “today you do not have as;” anyway, I had an emg last Thursday which came back clean, but the numbers look low based on a google.

And I had major symptoms prior to the emg; I wanted to see what people thought because after reading some threads, it seems like people really know what they are talking about.

Also, I had ever other test to rule out other things.

Thank you for your comments.
 
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Nikki J

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First please read this
I know you did not as you posted in the wrong section. Please post only on this thread here

second if you wish you can repost your emg which was removed for your protection because it shows your name. Block identifying information before posting

third your emg was normal. You saw an ALS specialist and another neuro and apparently they saw no reason for concern. Those numbers are part of the ncs not emg. Even if they were significantly abnormal which they do not appear to be ncs abnormalities point away from ALS

you need to work with your doctor but your answers are not here. If the neurologists do not believe it is a neurologic issue work with your pcp
 

Seth Petraroli

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I'm sorry about posting to the wrong area; can you tell me bit more about your opinion regarding my nct?

And thank you so much for responding, Nikki.

Shouldn't other abnormalities show up beside potentially low conduction velocity?

I am just not sure what to do because my legs are so weak, and my twitching occurs daily, and the legs are progressively getting weaker.

Thank you in advance.
 

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Nikki J

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I think your ncs is normal. It was interpreted by a live trained specialist not you via Mr Google

even if it were abnormal as I already told you ncs abnormalities have nothing to do with ALS.

and I already advised you. Typing with one finger here. Reread
 

Seth Petraroli

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I thought NCS are specifically used to help diagnose ALS; what makes you think it is normal, and is it on the low side of normal?

Also, what do you think about all my symptoms and that I had them before the EMG?

Thank you so much again for your responses; I greatly appreciate it.
 

ShiftKicker

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Hi Seth,

Please make sure to read the link provided and review what Nikki has already made the effort to answer you with.

This forum is not a general health or even a neurology inquiry forum. It specifically exists to address the needs of those directly affected by ALS. This subforum exists to answer a few basic questions about ALS that are not answered in the "Read Before" post, but is not to be used in place of your doctors. If you have specific questions about your results, and as it pertains to your health and symptoms, please speak with your doctors. Your test results show no signs of ALS, so this forum is not the space to ask your non-ALS related questions.

Please take care
 

Seth Petraroli

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Shiftkicker, thank you so much, and I am so sorry if I inadvertently asked unrelated questions to ALS.

I've read past posts before signing up that dealt with possible early emgs.

I'm just very much concerned with mine and how even though I have muscle weakness, twitching and symmetric abnormal reflexes, they could still show a normal EMG.

I'm not seeing my neuro for 3 months, and I am desperate for answers from people who know what they are talking about.

Please, any specific info about my results and how it's not ALS will really help me.

Or if you are unsure and think it may be als, I just really want to know why you think it's either one.

Again, thank you so much; having this resource is much better than googling.
 

lgelb

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Seth, I don't know what you've been Googling, but it's led you sadly astray. The EMG is the part of the test you had that is used in diagnosing ALS, among many other conditions. It was normal, as the report clearly states. So was the NCS, which is used for diagnosing other types of nerve problems. Neither of these tests is supposed to reflect what you feel. They reflect whether there is damage to your muscles or nerves that affects their function. Is there a test to show that you have a headache? No. But if you have a brain tumor, it will show up on MRI. This is a similar thing.

Any combination of perceived weakness and balance issues is, if there is really something wrong, most likely to be something like a virus in a younger person. I would stay in touch with your primary care doc. And as with any possible systemic illness, paying attention to exercise, diet, hydration, sleep and stress is likely to be fruitful. But you have nothing to worry about as regards ALS or anything like it.

Best,
Laurie
 

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Thank you, my wife, an MD, said it sounded like it could be a virus that started with balance issues and could have caused residual weakness.

What scares me are all the other symptoms: muscle weakness, abnormal reflexes, twitching, etc.

But a lot of the moderators, I think you may have said it too, state that emgs/ncs are abnormal well before you become symptomatic (google even says this too).

Laurie, thank you again for your patience, and can you speak to that, emgs catching things well before symptom onset?

This forum is amazing; again, thank you so much.
 

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Seth with respect, read the link you were given at the start, read it twice and slowly, it actually does answer your questions very specifically. We created it so that our paralysed members don't have to keep typing the same things over and over.
Nikki has ALS and told you she can now only use one finger to type. Please stop and think about that. She doesn't use one finger because she never learned to type, she can only use one finger to type now.
You have had a lot of responses and information given to you on this thread, but there is nothing more anyone can tell you as you don't even have a tiny possibility of ALS. Your doctors will help you work through what else it might be, that is the appropriate way to approach whatever is going on.
 

Seth Petraroli

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I'm so sorry; I did not know that. Nikki, thank you again for responding to me. I greatly appreciate all of the moderator responses as well.

I'm very frightened about my symptoms because everyone says weakness plus twitching are hallmark signs of als, and I have both plus abnormal reflexes.

If my legs felt fine, I wouldn't be so worried, but every time I walk, they feel weak and painful, esp. my hamstrings and quads.

If I hadn't gotten the EMG, would this have changed anyone’s response based on my current symptoms?

My wife urged me to get the EMG because it's unequivocal and not subjective, like with reflexes and weakness (ex. some of the drs said I was hyper at the knee while others said I was normal).

Again, I'm so sorry. I'm just looking for a bit more clarity bc the docs sometimes just brush off my questions.

Also, I just wish I knew more about all the nct numbers and their significance.
 

Bestfriends14

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Seth,

It's failure that is the hallmark of ALS, plus clinical findings. You have neither that would be indicative of this disease, yet keep pushing back on the members with more and more questions. "Feeling weak" is not ALS. Had you read what Nikki had so kindly supplied, you would realise this. I sincerely wish you the best, but you really need to move on from thinking you have ALS; it's for your own good.

Take good care.
 

lgelb

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To answer your question, in ALS, the EMG sees damage in areas that the patient does not, yet. So when it is completely normal but someone has feelings of weakness, etc. we know that those feelings are not due to ALS.

It is not true that feelings of weakness + twitches = ALS. If that were true, everyone in this CIBALS subforum would have it. >99% don't. It is not even true that clinical weakness (that a doctor sees) + twitches mean ALS. Much more often that combination would have another explanation, such as an old injury, spine damage, etc.

And, of course, weakness and loss of sensation can relate to MS or stroke, but we see very little of that here, and both are visible on the tests that you had.

Not to mention that early ALS doesn't feature pain while walking and so on. Sensory nerves are not affected. It's worth asking about PT, checking your shoes, and so on.

As for reflexes, interpreting those is an art rather than a science, it's certainly not in your province, many factors can affect them, and not everyone with ALS even has abnormalities.

In short, diagnosing ALS and other neuromuscular diseases is a bit more complex than Google would have you believe. Take your clean EMG and run with it. Stay in touch with your internist. Live the relatively healthy life that PALS here would give a good deal to have.
 
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